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Ketones In Urine Child

Diabetic Ketoacidosis In Children

Diabetic Ketoacidosis In Children

GENERAL INFORMATION: What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your child's blood sugar levels become high because his body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces his body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in the blood. Ketones are dangerous at high levels. What increases my child's risk for DKA? Not enough insulin Poorly controlled diabetes Infection or other illness Heart attack, stroke, trauma, or surgery Emotional stress Being female What are the signs and symptoms of DKA? Your child may feel very thirsty, and urinate more than usual. He may have a fever. He may also have any of the following: Dry mouth, eyes, and skin Fast, deep breathing Faster heartbeat than normal for him Abdominal pain, nausea, and vomiting Fruity, sweet breath Mood changes and irritability Feeling very weak, tired, and confused Weight loss How is DKA diagnosed? Your child's healthcare provider will ask about your child's symptoms and how his diabetes is managed. He will look for signs of dehydration and check your child's height and weight. Your child's blood and urine may be tested to check his blood sugar and ketone levels. These and other tests will show if your child is dehydrated. He may also need an EKG to check his heart rhythm. Your child may need more tests to find out what triggered his DKA. How is DKA treated? DKA can be life-threatening. Your child must get immediate medical attention. The goal of treatment is to replace lost body fluids, and to bring blood sugar levels back to normal. Your child may need any of the fol Continue reading >>

Ketones Urine Test

Ketones Urine Test

Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. Continue reading >>

Kids And Ketones: Checking And Treating High Blood Glucose

Kids And Ketones: Checking And Treating High Blood Glucose

Low blood glucose levels usually have warning signs such as shaking, sweating and rapid heartbeat, but high blood glucose levels can be silent until things start to get out of control. The staff in the Joslin Pediatic Clinic has this advice. One of the vital warning signs of an impending diabetic crisis is the appearance of ketones in the blood or urine. For children with type 1 diabetes and their parents, understanding the role of ketones in a diabetic emergency and knowing how to check for them and what to do if your child has them can mean the difference between a good night’s sleep and many tense hours in the emergency room. (Ketoacidosis almost always occurs in people with type 1 diabetes) Too little insulin for too long a time initiates a cascade of hormonal changes in the body that can lead to the dangerous condition of diabetic ketoacidosis (DKA). If left untreated, it can lead to coma and death. In the face of inadequate circulating insulin, glucose builds up in the blood instead of moving into the tissue cells where it would be used for fuel. Without glucose to burn for energy, the body turns to fat for fuel. The special type of fat it uses is called ketones. Because ketones are an acid, the body needs to supply a base (the opposite of an acid) to neutralize their effects and maintain the blood’s natural pH. However, the body’s supply of base,such as NH3 (anydrous ammonia) (is limited and at some point the system is overwhelmed and the blood pH starts to decline. This drop in blood pH is one of reasons ketoacidosis is so serious. The body can’t accommodate changes in blood pH well. Illness can often be a precipitating cause of DKA. Infection can spike glucose levels and additional insulin is often required. If the needs for additional insulin aren’t Continue reading >>

Checking Urine Glucose And Ketones

Checking Urine Glucose And Ketones

Checking urine for ketones Urinary ketones are checked by dipping a chemically treated strip in a fresh sample of urine. The colour change is then compared to a chart. A purple colour means ketones are in the urine. Ketones are a sign that too much fat has broken down in the body. There may be a number of causes, such as too little insulin or the stress of an illness. Ketones are a cause for concern if they are present when the blood glucose is high (greater than 14 mmol/L or 250 mg/dL). Check urine ketones whenever: the blood sugar level is over 14 mmol/L (250 mg/dL) for 3 readings in a row your child is feeling ill, has a fever, or has vomited your child has symptoms of high blood sugar, such as increased thirst and urination the diabetes team asks you to check for ketones, perhaps when the insulin dose is being adjusted Have strips at home for ketone checking at all times. Make sure that the strips have not expired by checking the expiration date on the bottle. The bottle should be kept closed. Once the bottle is open, the strips must be used within 6 months. Note that strips are available to check for glucose as well as ketones in the urine. Follow the instructions on the package carefully, and ask your health care team for help if the instructions are not clear. Checking urine for sugar Sugar in the urine is usually checked only as a back-up to checking blood sugar, or to screen other family members. A chemically treated strip is dipped briefly into a fresh urine sample. The strip will change colour. After a certain period of time the strip will be compared with a colour chart on the box. A urine check showing no sugar means that when the urine was made the blood sugar level was below the renal (kidney) threshold (about 8.0 to 12.0 mmol/L, or 145 to 220 mg/dL). A u Continue reading >>

Ask The Diabetes Team

Ask The Diabetes Team

Question: From Houston, Texas, USA: Are moderately high ketones ever caused by anything else besides diabetes? I have IDDM but there's no prior family history. I found out that my 4 year old son had moderately high ketones in his urine the morning after the day I took him to the pediatrician for an asthma problem. I have a good pediatrician and I want to prepare myself for what he might say. My son has been sick for six months with asthma difficulties that get better only on steroids (liquids) but the wheezing and dry coughing comes back when the steroids wear off. He's never been this sickly. He has gained no weight and seems much skinnier to me, but last time I mentioned this to the doctor he said wait until he's well and we'll weigh him again. I'm thinking of asking for a glucose tolerance test. My son is terrified of needles and I don't want to push the unnecessary. Answer: Ketones are produced when the body breaks down too much stored fat to get extra fuel for energy. In fact, in normal metabolic conditions, the main energy source of our human machinery are carbohydrates (i.e., glucose). Quite often very young children with normal (or low) blood sugar are unable to get enough sugar from their stored fat and from stored sugar (glycogen) in the liver while they're are sleeping during the night or are in a "starvation" situation or not taking in normal calories and fluids: then most of the time they can have ketones in their urine in the morning. Stress and illnesses like asthma, flu, and infections, put a stress on the body of a child and this can make his body produce ketones. This usually occurs because in these conditions the body makes hormones like epinephrine and cortisol which cause the body to break down its own fat deposits; this would explain why your son h Continue reading >>

Dehydration In Children

Dehydration In Children

Dehydration means not enough fluid in a child's body. This can result from vomiting, diarrhoea, not drinking, or any combination of these three. Sweating or urinating too much can also cause dehydration, although this is far less common. Infants and small children are much more likely to become dehydrated than older children or adults. Causes of dehydration in children Dehydration is most often caused by a viral infection that causes fever, diarrhoea, vomiting and a decreased ability to drink or eat. Common viral infections causing vomiting and diarrhoea include rotavirus and winter vomiting disease (norovirus). Sometimes sores in a child's mouth caused by a virus make it painful to eat or drink, helping to cause or worsen dehydration. More serious bacterial infections can make a child less likely to eat and may cause vomiting and diarrhoea. Common bacterial infections include Salmonella, E coli, Campylobacter, and C.difficile. Parasitic infections such as Giardia lamblia cause the condition known as giardiasis. Increased sweating due to a very hot environment can cause dehydration. Excessive urination caused by unrecognised or poorly treated diabetes (not taking insulin) is another cause. Symptoms of dehydration in children You should be concerned if your child has an excessive loss of fluid from vomiting or diarrhoea, or if the child refuses to eat or drink. Signs of dehydration: Sunken eyes Decreased frequency of urination or dry nappies Sunken soft spot on the top of the head in babies (called the fontanelle) No tears when the child cries Dry or sticky mucous membranes (the lining of the mouth or tongue) Lethargy (less activity than normal) Irritability (more crying, fussiness) When to seek medical care: Seek urgent medical advice if your child has any of the follow Continue reading >>

Urine Tests For Diabetes: Glucose Levels And Ketones

Urine Tests For Diabetes: Glucose Levels And Ketones

The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>

Diabetes: Urine Testing For Ketones

Diabetes: Urine Testing For Ketones

Ketones in the urine mean that the body cells are using fat for energy instead of glucose. A large amount of ketones in the urine is a danger sign and can mean the start of a serious illness. Call your child's doctor or nurse educator if your child has a large amount of ketones in his/her urine. Things that can cause the urine ketone to be positive are: too much food injury or illness too little insulin infection dehydration certain medicines Urine is Tested for Ketones: Whenever your child does not feel well. If your child's blood glucose is greater than 300 (or as directed by your child's doctor). Your child's doctor will tell you how often you should check your child's urine for ketones. To Collect a Urine Sample: Have your child urinate (void) into a clean container or on the test strip. NOTE: If your child wears a diaper, try placing cotton balls in the diaper and squeeze the urine on the test strip. What You Will Need: Fresh urine sample Ketone strip Pen or pencil Record Book Clock or watch with a second hand Ketone strip color chart Procedure Using Strip Method: There are different kinds of strips that can be used to check for ketones in the urine. Several kinds are Ketostix®, and Ketodiastix®,. Read the instructions on your brand. You may want to ask your pharmacy to order individually wrapped strips because opened bottles expire in 90 days. Check the date on the bottle to be sure the strips are not expired. Dip the strip into the urine. Wait for the amount of time stated for the type of strip you are using. Compare the color of the strip with the color chart. Record your results, date, and time in record book. Throw away urine and strip. Call your doctor or nurse educator if you have moderate or large ketones. Disclaimer: This information is not intended to s Continue reading >>

Value Of Point-of-care Ketones In Assessing Dehydration And Acidosis In Children With Gastroenteritis.

Value Of Point-of-care Ketones In Assessing Dehydration And Acidosis In Children With Gastroenteritis.

Abstract OBJECTIVES: Children with gastroenteritis often develop dehydration with metabolic acidosis. Serum ketones are frequently elevated in this population. The goal was to determine the relationship between initial serum ketone concentration and both the degree of dehydration and the magnitude of acidosis. METHODS: This was a secondary analysis of a prospective trial of crystalloid administration for rapid rehydration. Children 6 months to 6 years of age with gastroenteritis and dehydration were enrolled. A point-of-care serum ketone (beta-hydroxybutyrate) concentration was obtained at the time of study enrollment. The relationship between initial serum ketone concentration and a prospectively assigned and previously validated clinical dehydration score, and serum bicarbonate concentration, was analyzed. RESULTS: A total of 188 patients were enrolled. The median serum ketone concentration was elevated at 3.1 mmol/L (interquartile range [IQR] = 1.2 to 4.6 mmol/L), and the median dehydration score was consistent with moderate dehydration. A significant positive relationship was found between serum ketone concentration and the clinical dehydration score (Spearman's rho = 0.22, p = 0.003). Patients with moderate dehydration had a higher median serum ketone concentration than those with mild dehydration (3.6 mmol/L vs. 1.4 mmol/L, p = 0.007). Additionally, the serum ketone concentration was inversely correlated with serum bicarbonate concentration (ρ = -0.26, p < 0.001). CONCLUSIONS: Children with gastroenteritis and dehydration have elevated serum ketone concentrations that correlate with both degree of dehydration and magnitude of metabolic acidosis. Point-of-care serum ketone measurement may be a useful tool to inform management decisions at the point of triage or in Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Ketones: Clearing Up The Confusion

Ketones: Clearing Up The Confusion

Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>

Urine Ketones - Meanings And False Positives

Urine Ketones - Meanings And False Positives

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>

Blood In The Urine

Blood In The Urine

Your child’s urine tests positive for blood during an annual physical. You’re understandably anxious and concerned. Most of the time blood in the urine is not a problem -- but occasionally it is. Dr. John Foreman, a pediatric kidney specialist, explains when an appointment with a specialist is needed. Studies in the United States, and other parts of the world, have examined large numbers of children and have found that hematuria, the medical term for blood in the urine, is a relatively common finding. In fact, two to five percent of school age children had tiny amounts of blood in their urine at some point in time during every day. About one percent of school-aged children continue to have blood in their urine when it is repeatedly tested. While this might seem scary, most causes of hematuria are harmless. Only a very few children who continued to have hematuria had serious kidney problems. The vast majority remained perfectly healthy and the blood disappeared after a number of years. Usually the blood cannot be seen with the naked eye and can only be detected in the laboratory using a special urine dipstick that measures blood, protein, sugar, ketones, and products from bacterial infection. The urine dipsticks are very sensitive and turn positive with tiny amounts of blood that may be seen only when the urine is observed under the microscope (called microscopic hematuria). Most of the time blood in the urine causes no pain to your child. Even when blood is visible to the naked eye, it is very rarely a lot of blood, so you don’t have to worry about your child losing too much blood. Causes of Blood in the Urine Besides kidney problems, there are other causes of hematuria. The tests that your doctor may perform depend on whether there are other findings from the uri Continue reading >>

Testing And Your Child

Testing And Your Child

An essential part of managing your child’s diabetes is frequently testing their blood sugar levels (also known as blood glucose levels) to help avoid highs and lows – and knowing when to test for ketones. At times, this testing may be difficult – both for you and your child, especially if they’re very young. Good diabetes management is important both for your child’s day-to-day health and to help prevent any diabetes-related problems in later life. Regular testing of your child’s blood sugar level is a key part of this. Your paediatric diabetes team will give you a blood glucose meter, used to check your child’s blood sugar levels. Normally, there are a few to choose from and your diabetes team will help you and your child make the right choice. Your meter comes with a finger-pricking device and an initial supply of lancets (to take a drop of blood from the finger) and testing strips (to apply a drop of blood to, in order to get the result). Your diabetes team will also explain to you how to get further free supplies of these on prescription from your GP. Many parents worry or are anxious about testing their child’s blood sugar levels. Pricking their fingers can be painful, especially at first, and no parent wants to hurt their child. Then there’s the anxiety about what the levels will be. You’ll be told your child’s target levels to aim for, and it can be frustrating and even scary if you’re not meeting these. Wash your child’s hands. Prick the side of your child’s finger rather than the tip, as this keeps pain to a minimum. Don’t prick too near the nail and don’t prick the index finger or thumb. Devices are now available that allow you to take blood from different parts of the body, such as the base of the thumb or the arm. Talk to your Continue reading >>

Ketones And Children With Type 1 Diabetes – What’s Important?

Ketones And Children With Type 1 Diabetes – What’s Important?

What are ketones and when do you check for them in children with type one diabetes? This is a common question I get! I think when children are diagnosed, this a frequent part of the education that is easily forgotten or misunderstood due to the overwhelming amount of information being taught. So let’s look at why we would check ketones, how to check them, what the colors on the strips mean, and what to do if ketones are present. Why Check Ketones: When someone with type 1 diabetes does not not get enough insulin, their blood sugar levels rise, so the body is forced to use fat for energy. When fat is used for energy for an extended period of time, ketones develop. Ketones are a waste product of fat. If someone with type 1 diabetes does not get enough insulin, diabetic ketoacidosis (DKA) can develop. The length of time it takes and how high one’s blood sugar are varies, however DKA can occur in a few hours. Symptoms of DKA: high blood sugars ketones in blood and urine nausea, vomiting, and abdominal pain confusion lethargy (tired, sluggish, weak) difficulty breathing unconsciousness DKA is a very serious and life threatening situation. Speak with your health care providers to determine how you are to treat ketones and when you are to go to the emergency room. When to check ketones: Your doctor can tell you exactly, but usually when your blood sugars are over 250, especially if the blood sugar is not responding to insulin and remaining high after the second blood sugar check. Always check ketones when your child is sick, even if blood sugar numbers are not high. Anytime your child has nausea and vomiting, check ketones. How to check ketones: Ketones can be checked by using ketone urine strips. To check ketones, urinate on a strip, or collect urine and dip stick into ur Continue reading >>

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